NPIMap

Organization Active NPI

Arms Acres, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Port Ewen, NY
National Provider Identifier
1417147273
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
100210666 Issued in NY
Legal business name
ARMS ACRES, INC.
Practice address
319 Broadway, Route 9W
Port Ewen Education Center, 1St Floor
Port Ewen, NY 12466-5501
Phone
(845) 339-8707
Fax
(845) 339-2610
NPI assigned
Jul 27, 2007
Last updated
Apr 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patrice Wallace-Moore, LCSW-R
Title
Executive Director, Liberty Managem
Phone
(888) 227-4641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 100210666 NY Primary

Addresses

Primary practice location

319 Broadway, Route 9W
Port Ewen Education Center, 1St Floor
Port Ewen, NY 12466-5501

Mailing address

PO Box 1841
Albany, NY 12201-1841
Phone (518) 952-8408

Other identifiers 1

IdentifierTypeStateIssuer
01420795MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Arms Acres Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1417147273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1841",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011841",
            "telephone_number": "518-952-8408",
            "fax_number": "518-399-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 BROADWAY, ROUTE 9W",
            "address_2": "PORT EWEN EDUCATION CENTER, 1ST FLOOR",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124665501",
            "telephone_number": "845-339-8707",
            "fax_number": "845-339-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARMS ACRES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "WALLACE-MOORE",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, LIBERTY MANAGEM",
        "authorized_official_telephone_number": "888-227-4641",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "100210666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Ewen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.